Tuesday, October 20, 2020

Frequently Asked Health Care Questions



Q.

Who is eligible to become a Participant in the Plan?

A.

Apprentices and Active members who have met the required monthly premium as established by the Trustees.

Q.

What if I don’t work enough hours to gain eligibility for the month?

A.

Members are eligible to make a self-payment and/or apply for the Benevolent Fund.

Q.

How do I maintain my monthly Health Care coverage?

A.

Contributions equal to the required monthly premium cost as established by the Trustees must be made on your behalf.

Q.

How do I make a payment towards the continuation of my Health Care coverage?

A.

You can write a check to Plumbers Local 55 Health and Welfare Fund and mail it to the Fund Office at P.O. Box 99427, Troy, MI 48099-9427.

Q.

Whom should I call if I have questions about my Health Care eligibility?

A.

Please call the Fund Office Eligibility Department at (844) 344-2715.

Q.

Who are my eligible dependents?

A.

A covered employee’s lawful spouse, a covered employee’s child or dependent as allowed under the plan.

Q.

Will my child(ren) who is/are age 19 through age 26 be covered under the Plan?

A.

Yes, if they are not eligible for employer sponsored coverage other than that from either parent.

Q.

How do I add my new baby or spouse to my insurance plan?

A.

You will need to submit a vital form, a birth certificate, or marriage certificate to the Fund Office.

Q.

Whom should I contact if I'm getting a divorce and what documents do I need to submit?

A.

Please call the Fund Office Eligibility Department at (844) 344-2715 and the Pension Department at (216) 503-1184.

Q.

How do I obtain a replacement Medical and Prescription Card?

A.

Please call the Fund Office Eligibility Department at (844) 344-2715.

Q.

How do I inquire about the status of my medical claim?

A.

Contact Medical Mutual of Ohio at (800) 382-5729.